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Blood Bond
- eBook - ePub eBook: $7.99
As a vampire, Anna Strong has an immortal life...but now she's running out of time.
Anna's relationship with shape-shifter Daniel Frey has given her hope for a future with him and his son—especially when Frey proposes…
But just when Anna starts to think her life couldn't be better, she must fly to France to be at the side of her dying mother. There she learns that not every vampire accepts her Chosen One status. And one such vamp is about to go rogue—by leading his followers in a fight to usurp humanity…
I pull the Jag into the parking lot and reluctantly shut off the engine. My business partners, David and Tracey, are already in the office. I know because I'm parked right next to David. He and Tracey have taken to driving together and I can tell where they spent the night by whose car is in the lot. This morning, it's David's big, yellow Humvee.
I should have been inside by now, too, kneedeep in tax reports. The notsofun side of a successful bountyhunting business. To make it worse, the sun is bouncing off the bay with the intensity only a cloudless San Diego spring day can generate. I want to be outside basking in itnot trapped inside, working.
But duty calls.
Halfheartedly, I drag myself up the path to the door.
Tracey looks up and smiles a greeting, but David frowns.
"You were supposed to be here an hour ago. We have to get this stuff to the tax attorney by noon."
I slump in my chair. "Yeah, yeah. What do you want me to do?"
He hands me a fistful of receipts. "Sort these by date."
I take the pile and spread the receipts on the desk. Mechanically, I sort.
"We've had a good year," Tracey remarks, her eyes zeroing in on the bottom line of an income statement.
"Too good," David grumbles. "And if we don't get this tax stuff to the attorney by noon, what hard work giveth, the tax man will taketh away."
"I hear you, David. Look. I'm sorting, I'm sorting."
David drops his eyes back to the pile of paper on his side of our partners' desk. Tracey has pulled a chair up so that they are seated side by side and it strikes me what a goodlooking couple they are. David, ex–football player, sixfootsix tall, still the same weight and shape as he was when he played for the Raiders. Tracey, excop, bundle of energy, her auburn hair pulled back in a ponytail. I can't remember why I was skeptical of her when David first brought her on board. I had no reason to be. We even have the same fashion senseeach of us perennially dressed in jeans and Tshirts. That should have been enough to bond us in itself.
David looks up, catches me watching him. But instead of making some comment about how I'm not working, his expression shifts from irritation to sly mischief.
Uhoh. What now? I brace myself.
"So, Anna," he says. "You went out of town last weekend."
"Did you do anything special?" Tracey pipes in, batting her lashes.
What the I shift my gaze from Tracey to David, narrow my eyes. "Why don't you tell me? And since when have my weekends been a topic of conversation? "
David leans back in his chair and laces his fingers behind his head. "Since you started spending a lot of time with that friend of yours in Monument Valley. Is there something you want to share with us?"
"Like what?"
"Like is it getting serious between you two?"
I frown, sifting several variations of "none of your fucking business" through my head until I come to the realization with a start. It is their fucking business. They are my partners and my friends. I turn that old frown upside down. "Yes."
David almost slips backward off his chair. Scrambling to regain his balance, he grunts, "Wow. That's a first. He's not just a fuck buddy? You actually admit you have a serious relationship?"
Tracey leans forward, all big eyes and girlish enthusiasm. "Ooooh. Tell me about him. When will I meet him? What's he like?"
I have to mull that over in my mind. There are more things I can't say about him to my human business partners than I canlike the fact that he's a shapeshifter, that his other form is panther, that his son is already manifesting his powers as a shapeshifter years ahead of the curve, that he's saved my vampire ass more than once over the past year and a half I've known him.
I draw in a breath and meet Tracey's gaze. "He's generous, handsome, strong. Has tremendous endurance." A wink to her here. "Has a fiveyearold son that I'm crazy about. And he loves me almost as much as I love him."
I hear a gasp from David. "Holy fucking shit. You sound like a girl."
"She is a girl, stupid," Tracey snaps. "Jesus." She turns to me. "He sounds wonderful. And I'm getting so jealous. When do I get to meet Mr. Wonderful?"
"In two weeks. His son has a school break the middle of March and they're spending it here."
"What's his name?"
"Daniel Frey."
"Frey lives in Monument Valley now? And he has a son?" David asks, startled. "Since when?"
I forgot that David met Frey several months ago. They spent some time together at a local bar while I slipped out to attend to some vampire business. "He moved a while ago. I didn't find out about his son myself until just recently."
A white lie. Frey told me about his son the same time he distracted David so I could sneak away. I did just meet JohnJohn, though, right after Christmas.
"Wow, that's so romantic," Tracey says.
David sticks a finger in his open mouth and makes a gagging sound. "Jesus. Is this what I'm going to have to listen to in the office now? You two hardasses cooing like characters in a romance novel?"
I get out of my chair and cross to his side of the desk, leaning down so we're eye level. "I have just three words for you," I growl. "Gloria. Fucking. Estrella."
"Who's that?" Tracey asks.
Color floods up David's neck.
I grin. "Ask him to tell you about her sometime," I reply. "Now that's a story out of a romance novel."
David grows suddenly quiet, busying himself with a stack of papers he's probably been through a dozen times.
"Who's Gloria Estrella?" Tracey repeats. Then she stops. "Wait a minute. The Gloria Estrella?"
You can see the gleam of recognition spark in her eyes. "You told me you had dated a Gloria, but Gloria Estrella? She was your ex?"
"That was before you moved to San Diego and joined SDPD," David blurts. "It's been over for a long time!"
"You mean you missed the glamorous couple on the cover of People every other week?" I can't believe I'm spouting off like this, but once started, the sarcasm pours forth. "The actress and the football player. They were news, baby!"
David shoots me a look that's pure poison. "That's enough, Anna. Unless you want me to enumerate your lessthanstellar relationships."
But his tone is more hurt than angry and I'm suddenly flooded with guilt. It was unfair to bring Gloria into the conversation. Gloria Estrella was the big, stupid, "you are the love of my life" mistake every one of us makes at least once. David loved her to the depths of his soul, refusing to see what lay beneath the gleaming façade.
Yes, she was beautiful, a successful model and actress, but she was also vain, selfcentered and utterly without conscience. David is handsome, trusting, an ex–football player of some local renown. Perfect for Gloria to use as a camerafriendly public consort and since I was his partner and friend, perfect to use me to save her ass with the police when she screwed up. Which she did on more than one occasion. Big time. But it came to an end when I saw what she was doing to David. I made a bargain with her. I'd help get her out of yet another scrape (a very big one) if she promised to let David go. I did and remarkably, she's kept her word.
It took David a long time to get over her.
And now, I've raised the specter again. Just when he and Tracey were beginning a relationship of their own. Tracey is an excop, almost as tough as I am, and just as streetsmart. She and David do make a good couple, and she's more than a match for any of David's exes, except maybe Gloria.
Tracey is about to start asking questions again, I can see it in the confused way she looks from David to me.
I made this mess; I'd better clean it up.
I wave a hand and laugh. "Foget it, Tracey. Gloria is old newsa joke between David and me. It was over a long time ago."
I see David's shoulders relax ever so slightly.
But so does Tracey. Her eyes tighten at the corners. "Are you sure?"
And then, as if stage directed to enter at precisely the right moment, the door to our office opens.
The three of us swivel toward it. I might be imagining it, but a wave of relief at the interruption is so palpable, our visitor seems to feel it, too. He pauses, hand on the door, his expression curious but detached.
"Am I interrupting?" Detective Harris says.
Shit. "When aren't you interrupting?" I groan under my breath.
He comes in and closes the door behind him. He is smiling, but he's a cop. A middleaged, builtlikeaboxer, craggyfaced bulldog of a cop. His smiles can't be trusted. He was involved in the Gloria Estrella fiasco, which brings David's shoulders up again. But we both know he isn't here about that longclosed case.
Harris strides over to the visitor's chair and pulls it up to the desk. He turns it around and straddles it backward, grinning. "Hope you all had a good holiday."
Small talk? And now he's grinning. Christ. This can't be good. When no one follows up with the usual banalities about how good their holidays were, I pipe in. "What can we do for you?"
Harris ignores my question and directs one to Tracey. "How's the bountyhunting business treating you, Officer Banker?"
"Exofficer," Tracey spits back with the malevolence of a striking rattlesnake, her ferocity startling us all.
Jaw clenched, she adds, "As you well know since it was at your recommendation that I was granted disability retirement."
I snap to attention at this unexpected bit of informationand at the heat in Tracey's response. I'd assumed Tracey had agreed to retirement after an offduty scuffle with an armed bank robber resulted in a hero's commendation and a back injury. Should have known after seeing Tracey in action with us that it hadn't been her choice to retire from the force.
She's on her feet now, gathering the tax papers we'd assembled and the sheaf of receipts I was working on and stuffing them into a large envelope with jabs that would do a boxer proud. "I'll take these downtown," she says, jaw tight. "Finish it there. See you later."
And she's gone . . . fairly flying out the door. David and I look at each other and then at Harris.
"Well. I don't think she likes you very much," David says.
Harris shifts in his chair. The fact that he didn't jump to defend his actions with Tracey makes me think he might realize he acted precipitously in forcing her to retire. "I'm sorry she's still so angry," he says.
David shakes his head. "It's not Anna and me you should be apologizing to. It's Tracey." He pushes back his chair and gets to his feet. "I'm going with her." He's looking at Harris, daring the detective to try to stop him.
Harris lifts his shoulders. "Tell her I didn't mean to upset her," he says quietly.
David mumbles something that sounds a lot like "right, you fucking jerk" and brushes past Harris.
Then it's just the two of us alone in the office.
"I see your social skills haven't improved."
Then, since I think I'm going to need fortification, I get up and head for the coffeemaker in the corner. "Want coffee?"
If Harris hears the reluctance in my offer, he ignores it. He joins me at the credenza and takes a mug off the counter. He pours creamer and what looks like a quarter cup of sugar into it before swirling the mug until I think the contents are going to spill over the sides and onto the floor. They don't.
I watch the performance with raised eyebrows. "Ever heard of a spoon?" I ask dryly.
He's already tipped the mug to his lips, but he allows a smile. "Haven't spilled a drop yet."
We take our coffee back to the desk. This time he plops himself down in David's chair. We drink for a couple of minutes until I can stand the staring contest no longer.
"Christ, Harris, are you ever going to tell me why you're here? "
He tilts his head back, draining his mug. "You can't guess?"
Sure, I can guess. He's been badgering me ever since the former chief of police, Warren Williams, was found murdered, burned to ashes, outside of Palm Springs several months ago. Of course, he doesn't know that Williams was a vampire. But the details of his death and the unconventional forensic evidence found at the scene, twohundredyearold DNA to be precise, and the fact that Williams and I were known to have had a contentious relationship have elevated me to the top position in his list of "persons of interest." No matter that there is not a shred of evidence to link me to the crime.
But I want him to bring it up so I stay quiet.
Finally, he does.
"It's about Judith Williams."
Not what I was expecting, though as bad luck would have it, I have knowledge of that Williams' death, too. Warren Williams' wife, also a vampire, met her own grisly end at the point of an arrow.
I feign innocence. "Chief Williams' wife? Didn't I read that she'd gone missing several months back?"
"You did. Is that all you know, what you read in the newspapers?"
Now I've been around long enough to know the cops don't generally ask questions they haven't already answeredat least to themselvesso I frame my reply around a question. "I thought the FBI had taken over the case?"
"They had, yes. But I was informed yesterday that they're no longer pursuing it. Which means to us real cops that they hit a dead end. Decided to clear it off their books and throw it back to the locals."
He pauses, watching me, as if waiting for some kind of response. You'd think he knew me well enough by now to know the odds he'll get one are as infinitesimal as the odds we'll ever share a bed. When I stare back at him, mouth clamped tightly shut, he finally gives up.
"So," he says, picking up the conversation as if he'd never hesitated, "I've got all these reports from the FBI investigation. And I'm exercising due diligence by going over each and every one, and imagine my surprise when a familiar name pops up." He gets up and walks back to the coffeemaker, casual as an old sweater, taking time to pour himself a second mug and going through the "sugar, cream, swirl and slosh" routine. Then he takes a breath and turns to face me with the smug expression of a movie detective about to expose the villain in a room full of suspects.
Only there's no room full of suspects. Only me. I know what he's going to say. Before he gets the chance, I figure I'll pop his balloon. "It's no biggie, Harris. Yes. I was in Monument Valley same time as Judith Williams. But I only saw her once. Ran into her at the lodge. She was with a man I'd never seen before. I was there with Daniel Frey visiting his son. We said hello to her, went our separate ways. End of story."
I touch the tip of my nose. Nope. It's not growing.
Harris puts his mug down on the credenza. "That's what the report said. Funny thing, it's just about word for word the same thing that you said about being in Palm Springs when Warren Williams was killed. And Daniel Frey was with you then, too."
I eye him over the rim of my mug and snort. "My, that is a coincidence."
I shouldn't have pushed it with that last sarcastic remark. Harris' patience explodes with the impact of a rock through a window. "There are a hell of a lot of coincidences with you, lady. I don't believe in coincidences. The FBI may have dropped the case, but I won't. Not ever. Get used to this face because I'll be looking over your shoulder every minute until I figure out how you managed to be in the vicinity of not one, but two murders." He pushes out of the chair. "There's something not right about you. You're a puzzle. I don't like puzzles. But I'm damned good at solving them."
He turns on his heels and storms out of the office. His threat, because that's just what it was, trails behind him like a bitter wake.
I put my head against the back of the chair. Harris and I have a relationship that teetertotters up and down. Not too long ago, I thought we might be on our way to becoming if not exactly pals, at least tolerant of each other. Obviously I overestimated.
His words echo in my head. Something's not quite right with me?
I get up and take our mugs back to the credenza.
A little overly dramatic but what a master of understatement. I'm vampire, for shit's sake.
I'm surprised he didn't ask me again about the mysterious twohundredyearold DNA found where Warren Williams' was killed.
At least that's one sleeping dog he didn't kick.
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text: No insulated tank for the Drake II. The ST743 tank for the original drake comes in a "D" version (i.e. SD) that is insulated. On the drake II tank, the only option is a right-hand trip lever. The same style tank as the ST743 is used on the low-budget Carusoe as well, so there is an insulated tank option for that toilet as well, but that's it.

subset: commoncrawl


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A week and half ago, Heather, Kevin and I went to Fort Worth's awesome Food Park. This particular weekend they were having a dog food drive for Homeward Bound. I, personally, forgot the dog food, but Heather, as always, is on top of it and brought some.
Our first truck to stop at was Red Jett Sweets to make sure we got our dessert. Heather had a Red Jett Velvet cupcake, while Kevin and I chose to be more adventurous, trying The B.M.T (bacon + maple together!). Next, it was to decide what to eat. The trucks for the night definitely gave us a range of food choices – Simply Dosa, salsa limon, Gepetto's Pizza and Easy Slider Truck.
Kevin decided on pizza as his dinner choice.
"First time I had Gepetto's Pizza. The crust was the best part. Perfectly cooked. The onions were awesome. I normally don't like onions but theirs were great. Perfect amount of cheese, pepperoni, and sausage. It was probably eight to ten inches around, cut into four pieces." -Kevin
I've had Gepetto's Pizza prior to this outing and I thought it was great then. Glad to hear from Kevin his thoughts are similar. It's really a good pizza, and he's so right about the crust. It was my favorite part as well.
Heather and I, so much alike in so many ways, both wound up at Easy Slider. We each got 3 sliders for $10. Not so shockingly, each got 2 that were the same – Sweet & Lowdown and The Roadside. I also tried the French Revolution and Heather's 3rd one was the Nutty Pig, which I must say is completely NOT something she'd normally order, but I don't think the Sweet & Lowdown would be something she'd order either.
The French Revolution does not have a picture as it's a specialty. It was my second favorite. Heather and I both really liked the Sweet & Lowdown. There's something about the strawberry jam and goat cheese that just made that burger. It was so good, that I can still taste it and now, I want one. We all tried the Nutty Pig, and surprisingly, a burger with peanut butter on it, not too bad. NOT too bad. My least favorite was most definitely The Roadside. I didn't even finish it.
I don't eat beef very often anymore so eating these were a bit of a risk for me. I'm glad I took the risk. I'm definitely going to get some more of that Sweet & Lowdown, maybe even my own Nutty Pig.
Now for the cupcakes, you remember, the ones we bought first. We didn't eat them first though. We were at least adult about that decision.
The Red Jett Velvet was just that – red velvet.
The B.M.T, however, oh my goodness. I'm beginning to think that bacon should just be in EVERY.MEAL.FROM.NOW.ON. Seriously. The bacon was in the actual cupcake and the maple icing on top. YUM! It worked so well together.
"Cupcake. The icing looked like dog crap but obviously (I guess) tasted better. Bacon was an unexpected flavor but I thought it was perfect with the maple flavor. A breakfast cupcake, for sure." – Kevin
**In Kevin's defense, the way cupcake shops "present" the icing is a bit on the "dog crap pile" side. We both really loved the cupcake as a whole though.
Sadly, there is no picture of said awesome cupcake because we were clearly eager to stuff our faces with them. Next time, maybe.
What did Heather think of The B.M.T?
She messaged me WHILE I was typing this to say she didn't like it. Hmph.
If you haven't been to a food truck park, or even had food from a food truck, you are truly missing out. I've had grilled cheese from one of the trucks, and you know what — BEST grilled cheese I've ever had. Not even kidding. Find out if you have in food trucks in your area and try it out. The trucks here in the DFW travel back and forth between Dallas and Fort Worth. That's pretty nice because you have the opportunity to try new ones occasionally.
Speaking of the DFW area — moms, moms-to-be, dads, grandmas and pas, there's a new consignment sale happening in Grapevine in April. These consignment sales are awesome and Growing Growing Gone is sure to be a hit just like others. If you're in need of new baby/kids items (clothes, toys, just about anything you can think of), plan to attend April 19-21 at the Grapevine Convention Center. See, it's even located right in the middle.


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{holiday gift guide | editor's picks : sarah, vancouver}
Thursday 6th December, 2012
01 Chateau Versailles [Vancouver] is dangerously right around the corner from my shop, and I have had my eye on this exquisite chair since I first laid eyes on it.
02 I'm always looking forward to trying new products. Not only is the packaging striking, but I have heard such wonderful things about this cream!
03 There will always be a place for the streamlined in my home, but handmade and unique items truly capture my heart—such as this sweet piece by José Esteves.
04 I have yet to try this scent, but I am willing to take the risk if not only for the beautiful packaging, but also for the amazing reviews that I have read.
05 Mary Jo's collection continuously catches my attention, and I believe even keys would look more lovely with this decadent key chain she has designed.
06 This ladylike top sits high on my wishlist, thanks to its bold look in combination with the prettiest, most dainty details along the [removable] peter pan collar.
07 Structured bags tend to be favorites, and this one, with its side details, yet bold lines would be a fantastic [and practically roomy!] addition to the wardrobe.
08 Astier de Villatte has always been a bit of a mysterious atelier to me. The creations are just extraordinary, and I find myself so drawn to the rustic elegance.
09 As most of my wardrobe is made up of dresses, this charming golden belt would be a lovely addition, and a nice way to add a touch of sweetness to different styles.
10 Even more incredible in person, I have been unable to forget Charlotte Hosten's necklaces — the perfect final touch to so many different outfits.
>>> read sarah's vancouver guide here | & also find her here : blog | twitter | pinterest | instagram
Sarah Klassen Contributor, Vancouver
Even as a girl, Sarah spent hours curling up with her mother in their home library, exploring fashion and décor magazines, reading Jane Austen novels, and looking through beautiful books. Educated in design and marketing, Sarah has a great deal of experience in the realm of design, decorating and retail. She enjoys writing, travel, bike riding, boutique shopping, and exploring her beautiful city with her soul mate. Considered approachable and warm, if you meet her on the street, she's likely to engage you in lively conversation.
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I love the chair too! It would look great in my apt. I love your style!
Wonderful items to put on my list! Adore!
THAT CHAIR! I can certainly see why you would have your eye on that. I never buy a fragrance unsniffed, but I've heard so many lovely things about that Byredo scent…I may try to see if I can get my hands on a decant.
The chair is perfect!
Love your giftguide. I want it all!
Following your blog on GFC
Suzanne from writtenbysuzanne
Just a few things:
Please note that due to the inordinate amount of spam, comments with links to other sites may not be published; all self-promotion & promotions of give-aways on other sites will not be published; additionally, please include your blog address in the box provided, and not in the body of your comment.


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So our TV stand just wasn't calling to me anymore. Trevor made it several years ago and it was great for what we needed then. It was a big cabinet that housed the TV. Then we got a bigger TV that wouldn't fit inside, so he hacked off the top of the whole thing. It was alright, but as with most things, after a few years I was ready for a change.
So I was on the hunt for a dresser. But they were really hard to come by - I blame in on the economy (because that's where everyone puts the blame!) - people are trying to be more frugal so they are either:
--Keeping their furniture longer instead of buying new things and giving their old things to Thrift Stores
--Shopping at Thrift Stores, taking all the good stuff, and driving up prices
My goal was a $20 dresser - I wanted it to have personality. The whole search for a dresser as a TV Stand started when I saw this one over at Less Than Perfect Life of Bliss:
Sad side story - I actually found something really similar to this for $20 on clearance at a Thrift Store, but I hadn't yet run the idea by Trevor and I wasn't sure if he was in on a dresser for a TV Stand. So after he said let's do it, we went back and it was gone - ugh! - a life regret that I didn't buy it on the spot. (I have a list of garage sale life regrets, when I didn't act fast enough - like that amazing loft bed ......anyways.....)
So after months of looking on Craigslist, at garage sales, etc, when I came across this one for $40 at a Thrift Store, I went for it. Kate assured me it was a good deal.
I painted it yellow - note to self, when painting yellow, prime - double prime even! I probably put on 8 coats of yellow, and I swear it still could use more. I love the personality in the curved drawer fronts. Picture of "in progress" - -
So I never loved my basement layout. With the new dresser, we rearranged - the couch is now where the TV used to be, and the TV is on the other way - - it makes things so much more open!
Thing still left to do:
--buy a bracket to hang the TV on the wall (like the inspiration photo) - - but those brackets are pricey, and it's not a have-to, so it'll probably be a while....
--hide the components - - The wall behind the TV is our storage room, so we plan to cut a hole in the wall and store the console stuff on a shelf in the storage room, with some sort of glass picture-frame thing so you can still use remotes - great idea, right?!? It's on the someday list.
But for now, I'm loving the new feel the dresser TV stand brings to the room - -


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and found 2 items
749cc, 45bhp, 80mph, Insurance group 8
The Dnepr/Ural machines are a real antiques roadshow, which can trace their roots back to the 1940s. First seen as a Cossack 650cc, the Neval Dnepr is basic two - or three - wheeled transport. OK, it isn't the most fashionable, fast or reliable bike in the world, but you can get it repaired by a cobbler in Uzbekistan for ...
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Whatever star quality the Philippe Starck-designed Aprilia Moto 6.5 may possess as a motorcycling design icon (and it has lots), it's sadly more than matched by its overwhelming 'averageness' in terms of performance. The Aprilia Moto 6.5 is OK, in a F650/Pegaso sort of way, but you've got to love to weird looks to contemplate it.
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text:
The FreeWave Technologies 3.4 GHz, Serial radio provides outstanding performance and versatility in a small footprint that is ideal for OEM applications. The board level 3400 SMR radio offers a cost effective solution that allows customers to incorporate wireless communications into a wide variety of applications. With more interface options available a surface mount design and no additional RF shielding, the 3400 SMR board level product has tremendous flexibility for use in applications around the world.
All radios are designed, manufactured and tested in Boulder, CO. For Military or Export only. (License required for Export.)


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I'm guessing, but if you made provisions to backflush and demineralize the thing, you may be able to use those same fittings to blow it dry for the winter.
How would one purge the water in a tankless water heater when winterizing a Northern Michigan cottage? Would it require an impractical disconnection of the tank in and out lines to attach air to it? Would save space but wonder if they are really a good choice. Thanks.
I'm guessing, but if you made provisions to backflush and demineralize the thing, you may be able to use those same fittings to blow it dry for the winter.
Jim DeBruycker
Important note - I'm not a pro
Retired Defense Industry Engineer; Schluter 2.5-day Workshop Completed 2013, 2014
Under each of the tankless water heaters we instll are a valve manifold set. Hot and cold can each be connected to a water hose and allowed to drain the tank by gravity. One could also adapt to air at each valve and blow air backwards on each side. A good plumber should have installed such valves for future needs. As far as if tankless water heaters are a good choice, there are a LOT of factors, both good and bad. Too many people think too highly of them with out knowing or being told the downside too. We put a lot of them in but I always give the customer a sheet of good/bad points before they make up their minds. I don't want to go back with my hat in my hand when something goes wrong and they say "I didn' know that." PS, the tankless isolation kit ad on the right side of the forum is an example of the manifold valve I refered to.
Last edited by mcconnellplumbing; 01-29-2011 at 09:35 PM. Reason: wanted to add a bit more
I've actually been thinking about one of these for our cabin. Draining our water heater is somewhat of a pain. I'm also concerned about corrosion from our acidic water. seems like tankless might be the way to go. . .
mcconnellplumbing , educating people on a product they have never used is the best thing to do . kudos to you for doing so , it sure saves a lot of headaches in the future when you hand them a piece of paper in advance that has all the pro and cons.
Seems eventough most people have internet , few consumers take the time to do some homework before hand.
I plumbed my house so I have 2 shutoffs at the lowest point in the system . When I go away for extended periods in the winter , I shut my well pump off drain the pump which has it's own drain valve , open the 2 shutoffs and drain all the pipes in the house.
I also empty the (whole house) water filter and walk away knowing that nothing will freeze.
It takes me 5 minutes to do all of the above.
When I return , I close the 2 the shutoffs and the valve on the pump , prime the pump by topping it up with some water, and I'm back in business in 5 minutes.
10 years and all is fine in Canadian sub-zero weather.
I used 3/4 inch flexible metal tubes with their own fittings and seals on the ends to hook up my tankless water heater , which makes lifes easier on the initial install and if I want to remove it later.
Cheers............................................ ................Vin.


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Here, take a look at this Wikipedia page:
Right at the beginning of that page it says:
"Poly(methyl methacrylate) (PMMA) is a transparent thermoplastic... ...and was first brought to market in 1933 by the Rohm and Haas Company, under the trademark Plexiglas.[4] It has since been sold under many different names, including Lucite and Perspex.
They're saying that Plexiglas is made out of PMMA, or polymethyl methacrylate.
Now, look further down on that same Wikipedia page under Artistic and Aesthetic Uses where it says:
"Acrylic paint essentially consists of PMMA suspended in water; however since PMMA is hydrophobic, a substance with both hydrophobic and hydrophilic groups needs to be added to facilitate the suspension."
What they're saying is that acrylic paints consist of extremely tiny blobs of hard clear and colourles Plexiglas (called "binder resins") suspended in water, and that a chemical is added to the paint to keep those tiny particles of plastic in suspension.
Now take a look at this page from the Rohm & Haas Company:
In paint-speak, the term "100% Acrylic" means the binder resins are made out of polymethyl methacrylate and "vinly acrylic" means that the binder resins are made out of polyvinyl acetate, which is often abbreviated to "PVA".
That web page from Rohm & Haas lists the benefits of using paints made with PMMA resins, and point #1.b is that under wet conditions, there is a "minimized chance of peeling and loss of adhesion".
They're saying that if you use a 100% Acrylic paint on the ceiling and walls of a bathroom with a shower that's going to create wet conditions for the paint, the paint isn't less likely to peel off.
However, when most people see paint peeling in a bathroom, expecially on the ceiling and high up on the walls, they attribute the problem to insufficient prep work prior to painting. This is probably the most commonly misdiagnosed problem when it comes to painting.


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Gas prices in LA County drop to $3.82 a gallon (searchable map)
Ed Joyce/KPCC
Gasoline prices continue to decline in Southern California, with the average price for a gallon of self-serve regular at $3.82 Wednesday in LA County.
The average price of a gallon of self-serve regular gasoline is $3.82 in Los Angeles County. The price continued its downward slide Wednesday and is at its lowest price since July. The record high of $4.70 was set October 9.
The Orange County average price decreased Wednesday to $3.78. The average price of a gallon of self-serve regular gasoline in the Inland Empire dropped to $3.78. The average price in Riverside and San Bernardino counties is 68 cents lower than one month ago.
The streak of dropping prices is good news for Thanksgiving holiday travelers. The Automobile Club of Southern California said about 3.3 million residents are taking vacations this week, about 87 percent of them by car.
The top five destinations for Southern California travelers are Las Vegas, San Diego, San Francisco, California's Central Coast and the Grand Canyon, the Auto Club reported.
|Los Angeles Gas Prices provided by GasBuddy.com
|Click here to add this map to your website.


text: Alzheimer's Disease Webcast More Than Dementia: Managing Multiple Conditions and Treatments Medically Reviewed by Ed Zimney, M.D. Print Email Tweet An older person with Alzheimer's or dementia often has other chronic medical conditions too. When meds and doctor visits pile up, how do you stay on top of it all and preserve quality of life? Join in as we talk with leading geriatric experts about the complex care often necessary for Alzheimer's and dementia patients. You'll get tips on how to recognize symptoms of common conditions before they get too serious, ways to cover large treatment expenses and how to talk with your doctor about maintaining good quality of life while optimizing treatment. Plus, you'll hear about new research showing connections between heart disease, diabetes and dementia and how those connections could expand your treatment options. As always, our expert guests answer questions from the audience. Announcer: Welcome to this HealthTalk webcast. Before we begin we remind you that the opinions expressed on this webcast are solely the views of our guests. They are not necessarily the views of HealthTalk, our sponsors or any outside organization. And, as always, please consult your own physician for the medical advice most appropriate for you. Now here's your host. Rick Turner: An older person with Alzheimer's or dementia often has other chronic medical conditions to contend with. When doctor visits, medications and bills are piling up, how do you stay on top of it all and preserve good quality of life? Welcome to this HealthTalk webcast, More Than Dementia: Managing Multiple Conditions and Treatments. I'm Rick Turner, and during the next hour we will talk about conditions to be on guard against as well as the complex care often necessary for people with Alzheimer's. We will also discuss ways to cover large treatment expenses. With us by phone today is Dr. Susan Rountree, assistant professor of neurology in the Alzheimer's Disease and Memory Disorders Center of Baylor College of Medicine in Houston, Texas. Welcome to HealthTalk, Dr. Rountree. Dr. Susan Rountree: Thank you. I appreciate the invitation to be on the program. Rick: It's our pleasure. Also with us on the line today is healthcare consultant and attorney, Stephen M. Schuster, who specializes in healthcare regulatory law. Stephen is the publisher and editor of healthcaresoundoff.com, a Web-based forum on how to cost effectively purchase healthcare services and products. Stephen, welcome back to HealthTalk. Mr. Stephen M. Schuster: Thanks for having me. Rick: Dr. Rountree, I want to begin with you. Can you briefly tell us what other common chronic medical conditions can be present in a patient with Alzheimer's? Dr. Rountree: Our patients with Alzheimer's suffer from other chronic medical conditions just like cognitively normal senior citizens. This includes illnesses associated with aging, stroke, high blood pressure, high cholesterol, heart disease, to name a few. The typical person with Alzheimer's disease has an average of four or five other medical problems. Rick: Uh-huh. So just like the rest of us, they are just getting older, and problems crop up. Dr. Rountree: Yes, they do. The age of onset typically begins around 65, and many of our patients are in their 80s or 90s when they develop symptoms. We generally think that most of the people who have Alzheimer's disease die from their other medical illnesses and not Alzheimer's. Rick: Uh-huh. And I didn't hear you mention cancer at all, Dr. Rountree. What's the association between people with Alzheimer's and cancer? Dr. Rountree: Well, that's interesting. I mean, cancer is a condition somewhat like Alzheimer's in that it's complex, and there are multiple genetic and environmental risk factors. Some dementia researchers have recently reported that the number of cases of cancer is reduced in those who have diseases like Alzheimer's disease or even Parkinson's disease. Rick: Reduced? Dr. Rountree: Reduced. Or what we call neurodegenerative disorders. And we have no understanding about that at this time as to what causes the inverse association between cancer and Alzheimer's disease. Rick: That's interesting. Dr. Rountree: So that's a relatively new finding. Rick: It's a new finding. Well, people living with Alzheimer's may not always be the most communicative. They might not speak up when they are not feeling very well. Do family members and others around them need to be extra vigilant about certain signs of declining health that are unrelated to Alzheimer's? Dr. Rountree: Well, generally people with mild-stage disease can communicate adequately and report symptoms to their care provider and to the physician. But those who have more advanced disease could forget about their symptoms if the symptoms are intermittent or have resolved, for example having chest pain, angina, and then it not being present and forgetting about it. So the spouse or the care provider plays a very important role here in keeping track of symptoms that the patient may have intermittently. Those who have very severe disease may not be able to complain. And they can develop other problems or other symptoms like behavioral problems if they experience uncomfortable physical conditions. Rick: Right. That brings me to my next question. What do people need to be on guard for, looking out for in those who might be in advanced stages as signs that something else needs attention? Dr. Rountree: They might be agitated or restless or want to move around all the time or even scream. Screaming or agitation or restlessness may or may not be related to an underlying physical ailment. Rick: Now, Dr. Rountree, I understand that recent studies have linked an increased risk for Alzheimer's to other conditions such as depression, heart disease and even diabetes. Are these links simply age-related, as we sort of mentioned at the outset, or is something else going on? Let's start with heart disease. What is that link there? Dr. Rountree: Well, heart disease and other cardiovascular risk factors are also risk factors for Alzheimer's disease. And we know that hardening of the arteries or atherosclerosis may increase your risk to develop Alzheimer's disease threefold. We don't know exactly why, other than perhaps that there is some damage to the blood vessels that causes impairment in nutrient supply to the brain cells. Rick: Right. Dr. Rountree: That's purely speculative. But other things that damage blood vessels in the brain like high blood pressure cause thickening, or even in Alzheimer's disease you get abnormal protein deposition in the blood vessels from amyloid. It doesn't just accumulate in the brain. It accumulates in the blood vessels. And one of the larger risk factors like lipoprotein metabolism is a risk factor for dementia. We know you can inherit certain risk factors that increase not only cardiovascular disease and risk for stroke, but also risk for dementia. So we don't know exactly why, but we think it can be one of the triggers. Again, we think the disease is due to multiple genetic and environmental triggers. Rick: Right. Dr. Rountree: And other things that enter the brain can also act as triggers. Rick: And when it comes to treatment then, doctor, can treating these vascular problems in early Alzheimer's patients actually slow the progression of the disease? Dr. Rountree: Well, I guess slowing the progression of the disease once you have the disease is a different question than preventing the disease from the beginning. Rick: Well, you can address both. Dr. Rountree: We think that it's important for younger and early middle-aged adults to minimize their vascular risk factors. Everything we know about Alzheimer's is that it probably is present and developing in the brain 10 or 15 years before people develop symptoms. So it's important to begin the prevention strategies in younger adults. Rick: Okay. Dr. Rountree: And some people think that if you do that and treat cardiovascular risk factors in younger adults, you might reduce the incidence of Alzheimer's disease by 50 percent. Rick: Wow. Is there evidence to that effect? Dr. Rountree: That's just hypothetical. Rick: I see. And then in terms of the slowing the progression, what about the other part of that question? Dr. Rountree: There is some evidence that control of high blood pressure or even interventions like exercise can slow progression of cognitive decline in elderly people. And people, again, who have established disease, interventions that might work before you have the disease might not work once you have established disease. Rick: Okay. Then talk to us about the link between Alzheimer's and diabetes. What's known about that link? Dr. Rountree: Well, diabetes is also a risk factor for stroke and vascular dementia, so in that way it could also be a risk factor for Alzheimer's disease. But early on in diabetes, there is a condition especially in adult diabetes where you have high levels of insulin, or so-called insulin resistance, and your body makes an enzyme that has to degrade insulin, and this same enzyme degrades amyloid, which are abnormal proteins that accumulate in Alzheimer's disease in the brain cells. And so these mechanisms might be overwhelmed in a condition where there is high circulating insulin levels in an individual, and so the amyloid isn't degraded properly. Rick: Amyloid is what forms plaques? Dr. Rountree: Yes. It's involved in plaque formation in the brain. So that's one suggested link between diabetes and Alzheimer's disease, the vascular link, the vascular risk factor and then the degrading enzyme that doesn't work efficiently. There are also other problems with diabetics. They get a wide range of age changes that are accelerated, inflammatory responses. And we know inflammatory responses damage brain cells further beyond just simple accumulation of amyloid and cause the tangle formation also in the brain that goes along with Alzheimer's. Rick: There is also some evidence, is there not, that using a nasal spray for insulin can actually help Alzheimer's patients improve their memory? Dr. Rountree: Yes. There have been some studies. This is research, nothing proven yet, but clinical trials are ongoing to evaluate the use of intranasal insulin in the treatment of patients with Alzheimer's disease. There are abnormal insulin receptors on the brain, and the brain cells don't take up glucose [sugar] properly, and there is some preliminary evidence that insulin in this situation may be beneficial even in patients that don't have diabetes. Rick: Fascinating. Then let's talk about the other disease I mentioned as possibly linked with Alzheimer's, depression. How much do we know about that connection? Dr. Rountree: Well, we don't know if depression contributes to the development of Alzheimer's disease or if another factor causes depression in Alzheimer's disease, but about a third of the patients who develop Alzheimer's disease have a history of depression either premorbidly [before they develop Alzheimer's] or at some time during their illness. Rick: Okay. Dr. Rountree: Some people think that the changes in the brain that are associated with Alzheimer's disease in the limbic system where the neurofibrillary tangles accumulate cause the depressive changes that we see in these individuals. Rick: Well, is there any evidence to suggest that treating the depression can help with Alzheimer's symptoms? Dr. Rountree: Only if an individual has very severe depression can it make them appear that they have Alzheimer's disease. Occasionally patients will respond to treatment of depression, and their cognition will improve. Of course, if someone is severely depressed and you improve their depression, they are going to be more alert and more attentive, but in terms of curing the Alzheimer's disease or treating it, unlikely. Usually these individuals have both conditions. They are comorbid or co-occurring conditions. Rick: I would think it's also fairly easy to miss depression in a person with Alzheimer's. Is that true? Dr. Rountree: Yes. Because sometimes these patients, many of them are apathetic or don't have a lot of initiative, and the family can mistake this for depression. They also don't have the symptoms, they don't complain of the same symptoms as other people, but they can be tearful or irritable or express feelings of guilt or worthlessness. Even some, many of them, if they are depressed, they will be able to answer questions about have you thought about suicide or do you enjoy your life? Patients can answer those types of questions, so you can evaluate it. Rick: I saw a recent report in the New York Times on the concern that some disruptive and combative people with Alzheimer's in nursing homes are being medicated with anti-psychotic drugs when, in fact, there is no evidence of psychosis. Dr. Rountree, how big of a danger can this be to a person's health, and how can families be on guard against that? Dr. Rountree: Well, I think the family needs to be an advocate and be aware of what their loved one is receiving, especially if they are no longer living at home and they have been institutionalized. Very clearly the anti-psychotic drugs should be used only after the full risks are disclosed. The atypical anti-psychotics received a black box warning in 2005 citing increased risk of death in people treated, elderly patients with dementia. And that risk of death was equivalent to one excess death for 100 treated patients. As to the risk of using these medicines, they extend beyond just mortality. They extend to triggering diabetes or causing low blood pressure, which can cause patients to black out or pass out or fall down. Sedation can cloud their cognition further as they can become more impaired cognitively. However, sometimes they're a necessary evil if the patient is a danger to themselves or others. Rick: I see. Well, Stephen Schuster, I would like to hear your take on this particular topic, the use of these anti-psychotic drugs. As an attorney and as a patient advocate, what would you add? Mr. Schuster: Well, drugs are prescribed by physicians, and so family members and caregivers need to have a direct relationship with their relative's physician in this particular situation to assure that there is medical necessity and to assure that the treatment that is being prescribed by the doctor is, in fact, what needs to be done. They need to get answers similar to the type that Dr. Rountree just gave. Rick: And back to you, Dr. Rountree, a person with multiple health conditions including Alzheimer's or dementia could be on a variety of different drug treatments, so how do people in that situation and their families manage these multiple medications and avoid some possibly dangerous drug interactions? Dr. Rountree: Well, I think each individual patient needs to have a primary physician overlooking and coordinating their care, and that's the responsibility of a primary care person, to make certain that people aren't taking drugs that have dangerous interactions with other medications prescribed by different doctors. That's always an issue. That's an issue for all geriatric patients. Rick: Are there some common examples of prescription drugs that may be problematic with others? Dr. Rountree: In regards to the patient with Alzheimer's disease? Rick: Sure. Dr. Rountree: Okay. In regards to the patient with Alzheimer's disease, there are certain drugs that would work against their anti-dementia drug medication. Anti-dementia drug medications are glutamate modulators, and cholinesterase inhibitors. The most important one in terms of drugs that work against other drugs would be the use of one of the cholinesterase inhibitors. That's the initial line of therapy for our patients with Alzheimer's is anything that is anti-cholinergic rather than cholinergic can impair the action of that drug, and they can become more confused. Other drugs that our patients probably should not receive would be drugs that are highly sedative. Rick: And does that apply to over-the-counter medications? Are there any common concerns there as well? Dr. Rountree: Well, a lot of the medicines that are sold over the counter like sinus allergy pills, ulcer medicines, anti-nausea medicines have potent anti-cholinergic side effects, so that would be a concern. Rick: Okay. And in terms of the team of doctors that should be managing the care of a person with Alzheimer's, from your perspective, Dr. Rountree, who should compose that team ideally? Dr. Rountree: Well, ideally you would, but that's not way the world is structured. Rick: It's not? Dr. Rountree: No. Especially in medicine. Rick: Okay. Dr. Rountree: We have a real problem with Alzheimer's patient care because it does require a number of experts to coordinate care. But the primary care physician shoulders the burden of diagnosis and management of Alzheimer's disease, and I would say that they are the point of contact for over 80 percent of patients and their caregivers. And specialists like neurologists or psychiatrists care for a very small portion of Alzheimer's disease patients. Rick: And in terms of managing this condition of multiple doctors if someone is in that situation, do you have any tips from your perspective that might be helpful? Dr. Rountree: Well, I think it's just important for the family or caregiver to determine who the primary doctor is going to be and to have them coordinate care with specialists. Again, they need to be an advocate and be aware of what medications are being administered and for what reason. And, of course, the caregiver should always attend with the patient any time that there is a medical visit because the patient can't be their own advocate, and they certainly can't tell the caregiver at a later date what went on at that visit. Rick: Stephen Schuster, I want to bring you back into the conversation now. What are the greatest financial concerns facing families dealing with Alzheimer's? Mr. Schuster: Well, the greatest concern is that health insurance policies and Medicare only cover the doctor visits associated with Alzheimer's, and none of the insurance covers the custodial day-to-day care that's necessary for an Alzheimer's patient. Rick: That's a big hole. Mr. Schuster: So there is really no money available to assist a person who is on a daily basis giving care to a relative who has Alzheimer's. Rick: So long-term care insurance, I hear you saying that's pretty important? Mr. Schuster: Well, long-term care insurance is important, but you have to purchase your long-term care insurance before you are diagnosed with Alzheimer's or dementia. Rick: Otherwise, it's a pre-existing condition. Mr. Schuster: And no long-term care insurance company will issue a policy in that case. Rick: Wow. Mr. Schuster: So one of the things that people who have risk factors can consider is purchasing long-term care insurance at an earlier age. Rick: Yes. Mr. Schuster: And at least getting some financial assistance from a policy that covers custodial care of some sort, if and when they contract or are diagnosed with Alzheimer's would be a good idea. Rick: And, Stephen, is there a given age at which you think that's probably a good idea? Mr. Schuster: Well, there is a second strategy. The age is at least by the time you are 50 in answer to your question directly. The second strategy might be to purchase a whole life insurance policy that builds up a cash value that you would have as some sort of savings to offset the cost of custodial care if, in fact, there are risk factors in your family that you are concerned about. Rick: Okay. Now, the focus of this program is people with Alzheimer's with other medical conditions as well. So what common financial issues arise when other chronic health conditions are there in addition to Alzheimer's, Stephen? Mr. Schuster: Well, now, in the case of Dr. Rountree's comments, she mentioned that most of the onset of Alzheimer's occurs after 65, so we are dealing with the Medicare program for the great majority of people who have Alzheimer's. And the other chronic diseases and the management of those chronic diseases, including the prescription drugs, are covered by Medicare after you meet your deductibles or your supplemental policy pays for certain expenses. Most of those chronic diseases that you have been discussing, diabetes, heart disease, vascular disease, are all maladies that are covered by the Medicare program. And you can utilize those chronic diseases to develop some kind of strategy in addition for the financial burden of Alzheimer's. For instance, a person with heart disease may need to be hospitalized. If that hospitalization is at least three days, and a very creative physician can figure out a way to have a treatment plan in which that person needs to move off to custodial care, Medicare will cover that custodial care for I believe it's 120 days now. Rick: I see. Mr. Schuster: So there are ways in the combination of diseases to get the kind of custodial care, home healthcare that might offset some of the costs that are also common with Alzheimer's. Rick: For a few months at least. Mr. Schuster: Yes. Rick: Yeah. So say you have just been diagnosed with Alzheimer's, just recently. In that situation, how can families plan financially not only to deal with the Alzheimer's but the very real possibility of dealing with multiple medical problems? You mentioned the other option was purchasing a whole life insurance policy. What else can they do? Mr. Schuster: Well, this is a total financial planning effort, and I would recommend initially that anybody in this situation go to the Alzheimer's Web site, which is at www.alz.org, and on that Web site there are a fair number of pieces of information that caregivers need to be aware of. Rick: Okay. Mr. Schuster: But one involves financial planning. Once you are diagnosed with Alzheimer's, you know you are going to be facing some very serious financial burdens if and when the disease begins to accelerate and more care is necessary. Rick: Yes. Mr. Schuster: And so what you need to do is sit down and literally do a comprehensive financial plan. Know what your assets are, know what your investments are, your savings, your ownership of real estate, your ownership of life insurance policies, and all of those sorts of things so you have a good idea of what your assets are, and you can in conjunction with your physician begin to anticipate when you are going to need additional care and do some financial planning to get that care. So step number one, go to that Web site, and at that Web site there is a list of things that you should look at and those that you need to consult like your family lawyer or your family accountant, your family financial advisor in order to move forward and anticipate when you are going to need additional money for expenses. Rick: I'm not sure if I am hearing you right, but it seems like you are saying, Stephen, that you take an analysis of where you are financially, and say, okay, here is what we have and here's what we can plan for. But what if what you need is more than what you can afford? Mr. Schuster: Well, eventually you will deplete your assets. And once you deplete your assets, you are eligible for Medicaid. Rick: Medicaid. Mr. Schuster: And Medicaid does, in fact, pay for skilled nursing care. And so you will be able to at the very least be able to be admitted to a Medicaid skilled nursing facility. Rick: But you have to be destitute. Mr. Schuster: You have to be destitute. That is correct. This is not a very happy conversation when it comes to this particular disease. Essentially, the way our healthcare system operates, this particular disease has been forgotten, and as a result people with it generally are required to use their own assets to cover the care they need. That's why you find so many people with Alzheimer's being cared for by relatives in the home. Rick: Yes. Now, in terms of determining where a person with Alzheimer's might go, if a facility might be able to meet their needs, especially if they have multiple health conditions, Stephen, what are good ways to find out what's a good facility and what's not, perhaps? Mr. Schuster: Well, there are a number of types of facilities available to the person with Alzheimer's who also has other conditions. First is adult day care. Now, there aren't a large number of these facilities nationwide, but there are quite a few. And adult day care is a way for a person to be watched over by a licensed professional, and at least the relative or caregiver has some comfort that during the time that they cannot be at home to be the caregiver. There is this type of facility. The prices for facilities like that vary, but they are not dissimilar to the prices for child day care because they need licensed professionals, they use space, and they need to deliver care. So I'm guessing that those types of places cost between $100 to $200 a week would be my guess. Rick: Okay. Mr. Schuster: The second type of facility that is available are continuing care retirement centers. And these are generally places that a lot of people like to move as they get older, and they sell their house, they liquidate their assets, and they use their assets to generate the funds necessary to rent a room or rooms in a continuing care retirement center. Rick: Yes. Mr. Schuster: And generally speaking, the continuing care retirement center provides you three meals a day, recreation, other types of facilities, exercise, swimming pools, buses to shopping centers, all of the things you need to maintain a certain amount of freedom. And as your disease progresses or as your multiple diseases progress and you need more care, a lot of these continuing care retirement centers have wings, and each wing has a different type of level of care depending on what you need, all the way up to that of a skilled nursing facility. Rick: So you will just pay more for more intensive care. Mr. Schuster: You just pay more, and the base rent for most of these places I would guess at this particular time is about $5,000 a month. Rick: Uh-huh. Well, Dr. Rountree mentioned earlier the importance of a family doctor in helping to be the sort of gatekeeper in all these multiple medications that people with Alzheimer's may be on. Can that same person be helpful in finding the right facility for someone with Alzheimer's? Mr. Schuster: Well, my work with physicians has been such that I am not sure that family practitioners are able to, unless they have had experience, recommend places to go. And the best way for at least institutional settings, is that all of these institutions, continuing care retirement centers with wings that can care for these diseases, Alzheimer's and all of the related diseases, nursing facilities and so on are licensed by the state that they are in. And each state has a system that surveys these licensed facilities, and those surveys are publicly available. And so you can go and look at these surveys and make some determination, one, as to whether the care is available that your relative needs, and two, you probably are going to be able to find out all of the qualified personnel that are employed as a result of the surveys being done. So that's one way to get some information. Rick: And, Dr. Rountree, I wanted to bring you in at this point. Did you have an opinion on this? Is this the sort of thing that you do, help people to find facilities? Dr. Rountree: Well, because we are at a dementia center, we have psychologists and some psychosocial support for our patients. Mentioned earlier was that Alzheimer's Association is a good resource for these legal issues, financial, healthcare, power of attorneys, and they are also a very good resource for the day care programs in the community. And what's available to help the caregiver varies from community. Certainly there are not as many programs in the rural areas as there are in the large cities. Houston has a number of excellent programs, even tailored to people with more mild stage dementia versus moderate or severe. Rick: Okay. Dr. Rountree: Or even facilities that care for people who are aggressive or potentially violent versus other people. So it depends on where you live. Again, the Alzheimer's Association can inform you about the community resources. The problem is that late in the disease patients require 24-hour-a-day care, not necessarily active care, but someone to be around them like an infant or a small child needs a caregiver, and usually it takes more than one person to do this. And the caregiver gets exhausted and people have to be institutionalized. And it's very difficult to find a nursing home that provides the sort of care that most of these individuals would receive at home were it possible to keep them there longer. Rick: And, Stephen, did you want to add anything else in terms of the types of facilities available? Mr. Schuster: Yes. There is a resource that someone might consider, and that's at www.caremanager.org, and that is the National Association of Professional Geriatric Care Managers. Rick: Okay. Mr. Schuster: It's a not-for-profit. And generally speaking, geriatric care managers have good knowledge of not only the programs in a particular geographic area but the facilities in a particular geographic area and are fairly wise and can give you some pretty good advice. I have had personal experience with a care manager, and it was worth every penny I paid. Rick: Good. And then speaking of paying pennies, staying on top of bills, Stephen, do you have any tips for how people can keep everything organized and a big picture in focus? Mr. Schuster: Well, as Dr. Rountree said, in the early stages most Alzheimer's patients can take care of themselves and are generally able to function on the day-to-day things that need to be done. But I certainly think that early on the patient and the relative need to set up a meeting with the family lawyer and get the types of powers of attorney that are needed so that the caregiver or relative can begin as the patient diminishes in their ability to deal with these issues to take them over. Eventually as the disease progresses, it's highly likely that a relative is going to have to pay the bills and stay on top of them. So I would suggest that some type of power of attorney be signed so that the caregiver has the ability to step in when the time comes that it's necessary. Rick: And you may have covered this already, but if someone is feeling overwhelmed by such a responsibility as that with the bills and keeping everything organized, are there resources that can help them? Mr. Schuster: Yes. There are two types of resources that are available. There are services that will do bill pays and make sure that timely payments are made, but you can use a patient navigator to help you through the system and deal with the bills. Or you can deal with a patient navigator who also has some financial planning background, and there are a bunch of them out there. All you have to do is go to any of the search engines and type in "patient navigator" and you will come up with a good number of options. Rick: So let's get to the questions for both of you, and we start with an e-mail from Miami, Florida. This person writes, "Should patients that have diabetes or heart conditions keep in mind that in their future they might be diagnosed with dementia and/or Alzheimer's?" So I think both of you might contribute on this. Dr. Rountree, I will start with you. Dr. Rountree: I think anyone as they age needs to be aware that they might develop Alzheimer's disease, as the statistics are that the disease doubles at age 65, and by age 85, 40 percent of the population is afflicted. So I think it's a concern for everyone. Rick: Not just those with diabetes and heart conditions. Dr. Rountree: Yes. Not just those with diabetes and heart conditions. Rick: And Stephen? Mr. Schuster: Well, by the time you are 65, if you have diabetes or heart disease, your ability to get separate insurance is pretty remote. So you're stuck with trying to figure out how you are going to live out the rest of your days with the assets you have. It's an unfortunate thing unless healthcare reform brings us some revisions to the benefit structure taking into account that this particular disease or this coupling of diseases is much more prevalent nowadays, and we might in healthcare reform think about having a benefit for them. Rick: We can always hope. Mr. Schuster: At least on the custodial side or the caregiver side. Rick: Right. Next we have an e-mail from Vancouver, Washington, and the listener says, "My dad has bladder cancer. The tumor was removed, but there has been discussion of following up with something called BCG, bacillus Calmette-Guerin, a cancer treatment where they use a catheter to administer a vaccine. The problem is he can't urinate for two hours, which with Alzheimer's is a real problem, and he can't administer the vaccine himself. Now the doctor is saying not to do the follow-up treatment because of his age and because of his Alzheimer's." This listener doesn't say what age this person is. "I feel that it is not right to try and prevent him from getting the cancer back just because of his age and condition. What do you think? Is there a time to just let go of medical help?" Dr. Rountree? Dr. Rountree: I think that is really a decision between the family and in regard to how they would know their loved one would want the situation to be handled, the staging of the disease, and the benefits of the treatment, if any. Clearly some of our patients are so impaired they can't cooperate with complicated regimens like not voiding for two hours. They wouldn't be able to do it. Generally we recommend our patients maximize their other healthcare because uncontrolled medical conditions can make your cognition worse. Rick: Yeah. It's a difficult question asked by this listener but one that really no one else can answer for them. Dr. Rountree: Correct. Rick: You have to make that decision on your own. Coming from Placentia, California is this next e-mail, "Is it advisable to continue with both Aricept (donepezil) and Namenda (memantine) for an 89-year-old female with dementia? Also, I have read that if a senior takes Detrol (tolterodine tartrate) or any other incontinence drug, they work against the effectiveness of the two memory drugs I just mentioned." Dr. Rountree? Dr. Rountree: Well, 89, the age isn't the reason to treat or not treat. Generally we treat our patients with anti-dementia drugs as long as there is cognitive ability to preserve in terms of can the patient still feed themselves? If you stop the drugs, they might not be able to. That will definitely increase the burden for the caregiver whether they are institutionalized or not. Can they still find the restroom? Are they continent? So you have to assess what functional abilities are still there and what cognitive abilities, and only when people reach a very profound stage of the illness should you decide to discontinue treatment. We know combination therapy is the recommended therapy for people who have moderately severe dementia. So without knowing anything about the stage of the illness, unless this individual is profound, I don't think the age is the reason to withhold therapy. In fact, the drugs might prevent the behavioral and psychological symptoms of the illness and probably slow the progression and keep people at a higher cognitive and functional level as long as they're given despite their level of severity. Rick: And what about the listener's concern that Detrol may work against the effectiveness of the anti-dementia drugs? Dr. Rountree: Detrol is an anti-cholinergic drug that we discussed earlier, and it is one of the drugs that could potentially work against the cholinesterase inhibitor that the patient is taking. Rick: Okay. From Raleigh, North Carolina comes this next e-mail, "My husband is in the final stages of Alzheimer's. He also has a severe heart condition with bypass and pacer, prostate cancer, Parkinson's, glaucoma, and a thyroid condition and a broken hip, which happened at the VA when he was put in the psych ward and had a "confrontation." How do people handle the cost of keeping someone at home? I am alone with no family to speak of and an aide that comes in when she feels like it." Stephen Schuster, what's your reaction to that? Mr. Schuster: Well, I am presuming having heard the reference to the VA that this person could have institutional support, and my recommendation listening to that story would be to find a way to utilize the ability to get institutional support through the VA, especially since there are multiple other conditions for which the healthcare system will make this person either in nursing care or in inpatient care taking account what's wrong with them. Rick: How can the VA help in this situation? Mr. Schuster: Well, I am presuming that if this person has a broken hip, and I can even remember the litany of… Rick: It's a long list, yes. Mr. Schuster: …maladies, that that person would be eligible for some kind of inpatient treatment, Alzheimer's not withstanding. Rick: I see. Mr. Schuster: And that's where I think she ought to examine the solution, is to talk to the VA about what is available to her husband toward the end of his life in an inpatient situation because it's obvious that she is in no way able to take care of him. Rick: Yeah. Not on her own there. Mr. Schuster: Not on her own, and she doesn't have caregivers who are coming in frequently enough to offset the needs. Rick: Yes. E-mail from Fort Worth, Texas, "What is the difference between dementia and Alzheimer's? My husband has Parkinson's, and I am wondering if it is dementia from the Parkinson's or if it is Alzheimer's." Doctor? Dr. Rountree: Well, I really wouldn't have a way of determining that unless I evaluated the patient, did a neuropsychological test, and did a physical examination and took a medical history. But if the doctor tells you that you have dementia, the next question you should ask is what type of dementia from the doctor, just like if they tell you you have cancer, you are going to want to know what type. Alzheimer's is the most common type of dementia. It accounts for 70 percent of the cases overall, and it accounts for about 90 percent of neurodegenerative illness that causes dementia. So just statistically speaking, most people with dementia, in fact, have Alzheimer's disease. Frequently, however, Alzheimer's is mixed with other diseases that cause dementia, like strokes or Parkinson's disease. Rick: So Parkinson's can cause it? Dr. Rountree: It can co-exist. And Parkinson's disease can definitely cause dementia, and it's also treated with the same medicines that we use for Alzheimer's disease. Rick: Okay. And we have a question about another type of dementia from Tennessee, "My husband has vascular dementia. He is being treated like an Alzheimer's patient. What is the difference, and will he have different symptoms with this different type of dementia?" Dr. Rountree: Again, if we are looking at the dementia pie, pure vascular dementia probably accounts for less than 5 percent, maybe 3 percent. And it's usually not something that the family is unaware of. Usually a patient has a big stroke, and following a stroke they have cognitive impairment. A lot of patients get told they have vascular dementia because they have some changes on their MRI that shows increased number of white matter, hyper intensity. Now, what happens in Alzheimer's disease or in vascular disease is many people can just have some Alzheimer's changes in their brain but they are not demented. In other words, at death they can do autopsies and find seemingly normal people with changes of Alzheimer's. What happens is two people might have similar amounts of Alzheimer's changes in their brain, and then the one person has a few small strokes, and that just upsets the balance, and that person becomes symptomatic. Pure vascular dementia is very rare, and, yes, we use the same drugs to treat vascular dementia as Alzheimer's disease. Rick: And are the symptoms parallel to those of Alzheimer's? Dr. Rountree: Well, to call is it vascular dementia, you have to have memory loss, and so anything that involves memory loss is similar to Alzheimer's disease. But having said that, the people with vascular dementia might have more emotional lability or tearfulness or crying or depression associated with their illness early on. Rick: We have a question from Miami, Florida, "Are there medicines for diabetes and thyroid issues that could cause problems for someone with Alzheimer's?" Doctor? Dr. Rountree: Well, diabetic medication, the only thing I can think of is if someone's blood sugar is lowered too much, then that can affect cognition. And I have seen patients that have been on insulin, and they have recurrent hypoglycemic episodes, and that can cause brain injury on top of Alzheimer's disease. But in terms of these drugs being sedative or anti-cholinergic, no. Those contraindications don't exist. Rick: We have a question from Taylorsville, North Carolina, "What vitamins have been proven to help with Alzheimer's?" Are there any of them that we know of? Dr. Rountree: Proven to help? Rick: That's what it says. Dr. Rountree: Not proven, but there has been one randomized clinical or controlled study done on high-dose vitamin E in 1997 that suggested that high doses of vitamin E didn't necessarily improve cognition, but it slowed functional loss significantly in people with moderate stage Alzheimer's disease. There is a lot of evidence from experiments that vitamin C is also helpful. So most dementia experts recommend a combination of vitamins C and E. The other problem is that there was also some studies that suggested extremely high doses of vitamin E could be detrimental to people who have heart disease or diabetes. So all these things have to be taken into consideration. We do think, though, drugs or vitamins or antioxidants are important for general health and for brain health. Rick: So that's your general approach with these alternative approaches to treating or to helping someone with Alzheimer's dementia? It's not a treatment per se, but it just sort of helps the general overall health? Dr. Rountree: We think that vitamin E and vitamin C are important in our patients with Alzheimer's disease, and we recommend it unless there are medical contraindications like diabetes and heart disease. Mr. Schuster: My question is for Dr. Rountree. Is the medical community organized well enough to deal with Alzheimer's dementia? You mentioned that almost 80 percent of Alzheimer's dementia is managed by primary care physicians, and very few specialists are involved. I am wondering whether the primary care community, taking into account that there is a severe shortage and they have plenty to do, are really the types of physicians that you ought to be taking a relative to when, in fact, the diagnosis is made? Dr. Rountree: Well, no. I don't think that our society is organized well enough to deal with Alzheimer's disease, and I think it's going to be a major public healthcare crisis. An it's an unfunded disease. It requires more than just medical care to properly take care of these people. Most of these individuals, they need counseling, the caregiver emotional state needs to be addressed. The caregiver needs to be taught coping strategies to improve their psychological health, the caregiver needs to know about realistic expectations with therapy. Where is this going to happen under the current medical system that we have? I think you had mentioned earlier the geriatric care provider, I think they are going to become more and more important in our society as someone who is an intelligent advocate, especially because a lot of our older patients are going into their senior years without a care provider. Rick: And with that, I think we need to start wrapping it up because we are just about out of time. But before we go, I want to get some final thoughts from both of my guests. So, Dr. Susan Rountree, what would you like to leave our audience with today in about 30 seconds? Dr. Rountree: In about 30 seconds, I would like the audience to take their loved ones to get evaluated to make sure they don't have dementia because the earlier we can start therapy and get the patient on effective systematic treatment, the better they will do over the course of their illness. And at that time, the patient still has capacity to make decisions about who they want to be their power of attorney or power for financial matters. Rick: Great. And, Stephen Schuster, what are your final thoughts for us, please? Mr. Schuster: Well, this is the second Alzheimer's show I've done, and I am tired of delivering bad news. And so I think that if healthcare reform is to happen, the Alzheimer's organization and the people involved with Alzheimer's need to start to think about what it is that these people need and try to find a way to provide the benefits to them. Or, especially as Dr. Rountree said, it's going to become a public health crisis. Rick: Great. Stephen Schuster and Dr. Susan Rountree, thank you both for joining us today. Dr. Rountree: Thank you very much. Mr. Schuster: Thank you, Rick. Rick: Thank you in the audience for following along and your great questions. From HealthTalk, I'm Rick Turner. Tweet Last Updated: 09/10/2008 This section created and produced exclusively by the editorial staff of HealthTalk. © 2009 EverydayHealth.com; all rights reserved. Next Article: #Healthtalk Rheumatoid Arthritis Awareness »


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LEGO aficionado and artist Julius von Brunk may have created a mouth-full of nostalgia. What he has dubbed as the "Domaster" is a LEGO-made art piece that's disguised as a classic first generation Game Boy, but that wasn't enough. With a few creative snaps, the piece is--wait for it--transformed into a Nintendobot, an awesome take on the Transformers of the same generation. It's the Turducken of fond late 80s and early 90s memories and an amazing modification to some regular LEGO pieces.
The Queens local is known for his custom creations. He's built entire Super Mario Bros. levels out of LEGO, ray guns, Gundams, and recreated entire movie scenes before. He's even got a pretty stellar LEGO tattoo. This guy knows his stuff and his latest creation lives up to everyone's expectations! Even the Tetris cartridge residing inside the Domaster is its own Transformer, aptly called the Tetrawing. It even has its own tiny missiles to keep up with the Domaster's battery-shaped arsenal.


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October 3, 2011ALMA Early Science has started! See the ESO press release for a beautiful ALMA/HST composite of the Antennae Galaxies, the first official ALMA image released. The full list of the 112 highest priority projects selected for ALMA Early Science, including titles, investigators, and short descriptions can be found here.
September 6, 2011The scientific and technical assessment of the 919 proposals submitted for ALMA Early Science Cycle 0 has been completed. Fifty science assessors and 25 technical assessors from all over the world have considered the expected scientific value and technical feasibility of all the proposals submitted. As a result, the most promising proposals have been selected as those most likely for completion using the initial 16-antenna ALMA capabilities. The 112 highest-priority projects cover a wide range of science and are distributed across the four broad ALMA science categories as shown in the accompanying pie chart. The observations to collect the data required to complete these projects are expected to start on 30 September or soon after.
August 29, 2011The first of twelve 7-meter diameter ALMA antennas has just been transported to the 5000-meter-high Chajnantor plateau.The four 12-meter ACA antennas have already been moved up to the high plateau, but this is the first of the smaller 7-meter dishes -which put the compact into Atacama Compact Array- to reach Chajnantor. It is seen in the centre of this photograph, surrounded by some of the other ALMA antennas. Penitentes ice formations are seen in the foreground.The larger 12-meter antennas of the main array cannot be placed closer than 15 meters apart as they would otherwise bump into each other. This minimum separation between antennas governs the maximum scale of the features that they can detect in the sky. The ACA is specifically designed to help ALMA make better observations of these extended objects.
August 19, 2011
The second installment of Science Verification data is now available. These datasets consist of observations of the merging galaxy system known as the Antennae (NGC4038/9), and two observations of the proto-planetary disk TW Hya. The Antennae dataset is the first mosaic data to be released by ALMA, and so we have provided a new CASA Guide for calibration and imaging. Please remember that ALMA is still in the construction phase, and while we think that the currently available datasets are impressive, the quality of data being collected using ALMA is continuously improving. The Science Verification data sets are available through the ALMA Science Portal, where you will also find links to the CASA Guides. In the accompanying image, the yellow solid contours show the molecular gas as traced by CO(3-2) from ALMA Science Verification data. The yellow dashed lines show the area covered by the ALMA Science Verification mosaic. Background image credit: NASA, ESA, STScI/AURA.
August 11, 2011ALMA is on track to start Early Science Cycle 0 observations on 30 September 2011 or soon after - this week we successfully collected data with 17 antennas (136 baselines). We now plan to start Cycle 0 observing in the compact configuration. The extended configuration is expected to be available by the end of 2011 and the timing of the reconfiguration to the extended array will take into account the subscription pressure for the two configurations. This change from the configuration sequence outlined in the Proposers Guide results in part from delays caused by challenging weather conditions at the Array Operations Site during the 2011 winter.
July 28, 2011The first European antenna has been transported up to the ALMA Operations site at 5000 m, bringing the total number of antennas there to 16. This is the number of antennas specified for the start of ALMA Early Science Operations, and therefore an important milestone for the project.
July 12, 2011The deadline for Cycle 0 observing proposals passed on June 30th, and now it is official: almost 1000 proposals from astronomers around the world were received for the first observing period of ALMA Early Science. The level of demand for observing time with ALMA corresponds to about nine times the number of observations that are expected be carried out during the first phase of Early Science.
June 22, 2011Yesterday, "first light" was achieved with DA41, the first European antenna. Used as a single dish at the Operations Support Facility (OSF), DA41 produced this quick-look total power map of Saturn - truly the very first image made with this antenna. Today, the first fringes were obtained on a baseline to a European antenna using DA41 and PM04 at the OSF. The target was the continuum source 3C279 observed in Band 3 at 86 GHz.
June 2, 2011The Joint ALMA Observatory announces the availability of the first two ALMA Science Verification datasets: 1) The protoplanetary disk TW Hya at Band 7 (0.87 mm); 2) The luminous infrared galaxy NGC 3256 at Band 3 (3 mm). The data sets are available here and include uncalibrated and calibrated data, as well as images and data cubes. Data reduction guides are also provided. The image on the left shows the CO map obtained for NGC 3256, with the velocity contours overplotted.
June 1, 2011The Joint ALMA Observatory announces the opening of the ALMA Science Archive. Proposals for ALMA Cycle 0 may now be submitted to the ALMA Archive until the proposal submission deadline at 15:00 UT on June 30, 2011. Proposers are reminded that ALMA proposals must be submitted to the archive using the ALMA Observing Tool, and that all PIs and co-Is must be registered at the ALMA Science Portal. For more information, and access to the ALMA Software Tools, please visit the ALMA Science Portal at http://www.almascience.eso.org
April 21, 2011The first European ALMA Antenna has been handed over to the Joint ALMA Observatory. It was moved from the Site Erection Facility , where it was assembled and tested, to the observatory's Operations Support Facility. The ALMA team can now begin to integrate the European antenna into the growing observatory, where it will join other antennas provided by the North American and East Asian ALMA partners. More...
March 30, 2011The ALMA Director is very pleased to issue this
Call for Proposals for ALMA Early Science Cycle 0
All the details are available at the newly-opened ALMA Science Portal, which is jointly provided by the ALMA Regional Centers operated by the ALMA Partners.
March 4, 2011The number of antennas for the Atacama Large Millimeter/submillimeter Array (ALMA) on the Chajnantor plateau has now reached double digits! The tenth antenna was moved up from the Operations Support Facility at an altitude of 2900 metres to the Array Operations Site at 5000 metres, high in the Chilean Andes, on 4 March 2011 using one of the ALMA transporter vehicles. More...
January 7, 2011The Joint ALMA Observatory (JAO) expects to start Early Science observations (Cycle 0) on a best effort basis late in 2011 and a call for proposals will be issued at the end of the first quarter of 2011. The purpose of Early Science will be to deliver scientifically useful results to the astronomy community and to facilitate the ongoing characterization of ALMA systems and instrumentation as the capability of the array continues to grow. Please see this announcement for more information on the plans for Early Science observations and the Science Verification program.
December 17, 2010The world's most sensitive receiver for radio waves with wavelengths around 1.5 millimetres has been delivered to ESO. The receiver - operating in a wavelength range known as Band 5 at ALMA - will allow scientists to trace water vapour in the nearby Universe, and will also provide an unprecedented view of the most distant galaxies. The delivery is an important milestone for the project for ALMA Enhancement of Early Science, funded by the 6th Framework Programme of the European Commission. The project has developed new technologies from scratch in just five years. The development of the receivers has been led by the Group for Advanced Receiver Development at Onsala Space Observatory and Chalmers University of Technology in Sweden and the STFC-Rutherford Appleton Laboratory (RAL) Millimetre Wave Technology Group in the UK. For more info see the ESO announcement.
December 11, 2010This picture captures the huge amount of antenna-related activity at the OSF in the three contractor camps and in the ALMA testing area. At the far left of the picture, antennasare being assembled and tested in the Vertex and MELCO contractor camps (note the first 7m antenna of the ACA in the Japanese contractor area). On the right-hand side, several fully assembledantennas are being fitted with ALMA equipment and tested in the ALMA testing area next to the OSF technical building. At the front left is the European antenna camp, where the AEM consortium is assembling and testing antennas to be soon delivered to ALMA. Six fully assembled AEM antennas are visible in the picture, while the seventh is being assembled within one of the container shelters. A detailed account of the ALMA status and progress towards Early Science is given in the December 2010 issue of the ESO Messenger.
November 22, 2010The ALMA Board confirms that ALMA is on track to begin observations in the second half of 2011, and expressed its appreciation to the ALMA and regional Executive staff and contractors for a great achievement. It is anticipated that the first Call for Proposals for Early Science will be issued in the first quarter of 2011. An official announcement will be made in January 2011. Full document including test images
November 5, 2010ESO hands over the ALMA Santiago Central Office headquarters to the Joint ALMA Observatory. More
October 6, 2010Halfway to the Early Science Antenna Array: the ALMA array at the high-elevation Array Operations Site (AOS) has now grown to eight antennas, half the number required for the start of Early Science. More
August 8, 2010The ALMA array at the high-elevation Array Operations Site (AOS) has now grown to seven antennas. More
July 22, 2010A new video compilation of footage providing a virtual visit of the ALMA site is now available here.
May 31, 2010On the Chajnantor plateau, the Atacama Large Millimeter/submillimeter Array (ALMA) is growing, the number of ALMA's state-of-the-art antennas on the 5000-metre-altitude plateau in the Chilean Andes having now increased to five. More
Jan 04, 2010For the first time in the ALMA project, closure phase has been achieved between three antennas working together as an interferometer. This massive achievement took place at the 5000-m altitude observing site in Chile and demonstrates that the ALMA system is working extremely well. Announcement
Nov 12, 2009The first fringes have been detected using a two-element interferometer at the 5000-m altitude observing site in Chile - a major milestone in the construction of ALMA! Announcement
- mid-2006: European ARC activities begin
- mid-2007: First antenna arrives in Chile
- mid-2009: Two-antenna interferometry at the OSF
- late 2009: Three-antenna interferometry and closure phase at the AOS
- early 2010: Commissioning and Science Verification starts
- early 2011: Deadline for Early Science proposals
- mid-2011: Early Science begins
- 2012: Inauguration
- 2013: Completion of Construction
ALMA antennas
at OSF (low site):
ALMA antennas
at AOS (high site):
There are two Web Cams at the OSF, WC1 and WC2. They allow you to watch the OSF construction activities and have been configured to show a picture every minute.
Upcoming Meetings and Events
More ALMA news...
- ALMA website: The main ALMA website maintained by the Joint ALMA Observatory
- Newsletter: Read the latest edition of the ALMA Newsletter


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The Pew Charitable Trusts is driven by the power of knowledge to solve today's most challenging problems. Pew applies a rigorous, analytical approach to improve public policy, inform the public and stimulate civic life.
Nov 24, 2009
After being overshadowed by the Fort Hood shootings for several weeks, the year's two major domestic policy stories—health care and the economy—re-emerged atop the news agenda last week.
But much of the media buzz, particularly in the talk show universe, revolved around the week's No. 3 story—Sarah Palin's book tour—which to some degree inevitably turned into a referendum on the press itself.
Coverage of Palin often seems to end up with the news media's behavior near the center of the narrative. And that was the case last week as media vetting of "Going Rogue" and her complaints about a Newsweek cover photo became issues in their own right.
From November 16-22, health care reform was the No. 1 story, accounting for 13% of the newshole according to the Pew Research Center's Project for Excellence in Journalism. The Saturday, November 21, vote to bring legislation to the Senate floor for debate—a significant, but far from decisive milestone—occurred too late in the week to have a major impact on this News Coverage Index.
The U.S. economy was the second-biggest story (at 12%), amid more mixed signals about the unemployment picture.
Read the full report Public Policy (and Palin) Drive the Week's News on the Pew Research Center's Project for Excellence in Journalism Web site.
The Pew Health Group's new Web site informs and engages people about issues that affect their health and well-being.
Spring 2012
Read articles on improving elections, the changing news environment, improving school lunch standards, and more.
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